Talent.com
Director of Care Management & Member Navigation
Director of Care Management & Member NavigationTRIARQ Health • Grand Rapids, MI, United States
Director of Care Management & Member Navigation

Director of Care Management & Member Navigation

TRIARQ Health • Grand Rapids, MI, United States
8 hours ago
Job type
  • Full-time
Job description

TRIARQ Health is a trusted partner to independent medical practices, enabling their independence and success in a value-driven healthcare ecosystem. We align with payers and enable practices with advanced technology, actionable insights, and tailored support that reduce administrative burdens, simplify operations, and drive sustainable growth—making specialists more attractive to members and referring providers.

We improve outcomes and affordability by proactively guiding members into evidence-based, conservative care pathways, ensuring they connect with high-value providers, avoiding unnecessary procedures, and enabling a coordinated care journey that balances quality, cost, and patient satisfaction.

Role Overview

The Director of Care Management & Member Navigation leads TRIARQ’s specialty care management programs, balancing strategic leadership with hands-on execution. This role oversees the design, implementation, and continuous improvement of care navigation, outreach, and engagement initiatives that guide members across their care journey—from diagnosis through recovery.

The Director will manage teams of therapists, nurses, care coordinators, and navigators, while also driving campaign execution, provider alignment, and payer reporting. A central responsibility is to implement multimodal engagement strategies, including one-to-many outreach tools, to improve patient adherence, provider compliance, and affordability outcomes.

Key Responsibilities

Program Design & Leadership

  • Build and scale care management programs across MSK, Urology, and other high-value specialties.
  • Develop standardized care pathways and plans with physician input; integrate payer medical policy into workflows to streamline utilization management and prior authorization.
  • Translate affordability and quality objectives into actionable interventions for care teams.
  • Collaborate with Member Experience, Program Management, and Provider Engagement teams to align strategies and priorities, ensuring care management programs are seamlessly integrated into operations and provider partnerships.

Operational Oversight & Execution

  • Lead daily operations of care management, including staffing, workflows, and queue optimization.
  • Design and execute one-to-many multimodal campaigns (digital, SMS, nurse calls, provider co-marketing).
  • Oversee member outreach scripts, provider playbooks, and navigator work queues to ensure closed-loop referral management and high-value care guidance.
  • Care Management and Navigation

  • Deploy early-intervention outreach at diagnosis and during key care transitions to keep members on conservative pathways.
  • Incorporate patient-reported outcomes (PROMs) and satisfaction measures to guide continuous improvement.
  • Optimize engagement cadence, messaging, and channels based on adoption rates, patient feedback, and affordability outcomes.
  • Provider Integration

  • Partner with PCPs, specialists, and allied providers (including PT) to align referral patterns, pathway adherence, and performance goals.
  • Conduct scorecard reviews and deliver feedback loops that drive provider accountability in value-based arrangements.
  • Manage escalation pathways by directing members back to the appropriate provider, ensuring timely follow-up, closed-loop communication, and accountability for ongoing care.
  • Analytics & Reporting

  • Use data-driven population stratification (early, chronic, episodic cohorts) to target care appropriately.
  • Track affordability, utilization, PMPM trend impact, pathway compliance, and referral adherence.
  • Provide regular reports to payers and internal leadership on engagement, outcomes, and financial performance.
  • Qualifications

  • Physical Therapist (PT) background strongly desired; RN or other clinical licensure would be considered.
  • Progressive experience in care management, population health, or value-based care.
  • Mission-driven orientation with a focus on patient-centered care and affordability.
  • Proven leadership of multi-disciplinary teams (PTs, RNs, navigators, coordinators).
  • Demonstrated experience with multimodal campaign execution for patient engagement.
  • Knowledge of payer-provider contracting and value-based arrangements.
  • Data-driven mindset with expertise in affordability and utilization reporting.
  • Excellent communication and collaboration skills with providers, payers, and patients.
  • Build-and-change mindset to create, manage, and problem-solve in a fast-paced environment.
  • Forward-thinking approach in the use of data and technology to enhance care management and member engagement.
  • Why Join TRIARQ?

    At TRIARQ, you will help transform specialty care by making healthcare more affordable, member-centered, and provider-aligned. Specialty utilization and spend represent nearly 50% of total healthcare costs, and we are focused on building a new care delivery model that aligns payers and providers to create better outcomes. This role is a unique opportunity to shape the future of healthcare while also rolling up your sleeves to execute—ensuring members feel supported, providers stay engaged, and payers achieve measurable affordability gains.

    You’ll be at the center of TRIARQ’s mission : guiding members through complex care journeys, enabling specialists to succeed, and proving that affordability and quality can go hand in hand.

    Create a job alert for this search

    Director Care Management • Grand Rapids, MI, United States

    Related jobs
    RN Case Manager

    RN Case Manager

    Interim HealthCare Home Health and Hospice • Greenville, MI, US
    Temporary
    Discover a new lane in nursing and earn top pay doing what you are made to do.The last few years have put unbearable pressure on nurses. The long hours, relentless demands and sacrifices have become...Show more
    Last updated: 12 hours ago • Promoted • New!
    Travel Nurse RN - Labor and Delivery

    Travel Nurse RN - Labor and Delivery

    LanceSoft • Fremont, MI, US
    Permanent
    LanceSoft is seeking a travel nurse RN Labor and Delivery for a travel nursing job in Fremont, Michigan.Job Description & Requirements. BLS, NRP, AWHONN, STABLE, MI state license required.Min 2y...Show more
    Last updated: 24 days ago • Promoted
    Travel Nurse RN - OB / GYN

    Travel Nurse RN - OB / GYN

    Arrow Healthcare Staffing • Fremont, MI, US
    Full-time
    Arrow Healthcare Staffing is seeking a travel nurse RN OB / GYN for a travel nursing job in Fremont, Michigan.Job Description & Requirements. Arrow Healthcare Staffing Job ID #17315393.Pay package...Show more
    Last updated: 2 days ago • Promoted
    Travel Labor & Delivery Nurse

    Travel Labor & Delivery Nurse

    AHS Staffing • Fremont, MI, US
    Full-time
    AHS Staffing is seeking a travel nurse RN Labor and Delivery for a travel nursing job in Fremont, Michigan.Job Description & Requirements. AHS Staffing is looking for a Labor & Delivery Regi...Show more
    Last updated: 16 days ago • Promoted
    Certified Dietary Manager (CDM) - Sign On Bonus

    Certified Dietary Manager (CDM) - Sign On Bonus

    The Laurels of Sandy Creek • WAYLAND, Michigan, United States
    Full-time
    Do you enjoy preparing delicious meals? Are you interested in joining a team that recognizes leadership and excellence in food service and guest hospitality? Would you like to cultivate your passio...Show more
    Last updated: 9 days ago • Promoted
    CRNA - Anesthesiology job available in Fremont, Michigan

    CRNA - Anesthesiology job available in Fremont, Michigan

    NorthStar Anesthesia • Fremont, MI, US
    Full-time
    Get the Recognition Youve Earned.Build Your Future with NorthStar.Join NorthStar Anesthesia as we continue our exciting nationwide expansion! Were seeking passionate CRNAs to help deliver excellenc...Show more
    Last updated: 30+ days ago • Promoted
    Local Contract Nurse RN - Dialysis

    Local Contract Nurse RN - Dialysis

    HeartCentrix Solutions • Hastings, MI, US
    Full-time
    HeartCentrix Solutions is seeking a local contract nurse RN Dialysis for a local contract nursing job in Hastings, Michigan. Job Description & Requirements.EXPERIENCE AND REQUIRED SKILLS : .Nephro...Show more
    Last updated: 9 days ago • Promoted
    Staff Development Coordinator RN

    Staff Development Coordinator RN

    Regency at Fremont • FREMONT, Michigan, United States
    Full-time
    Are you a nurse who is passionate about teaching others? The Staff Development Coordinator acts as the educator for Regency at Fremont, conducts orientation and has the opportunity to provide other...Show more
    Last updated: 30+ days ago • Promoted
    Home Health Physical Therapist

    Home Health Physical Therapist

    Graham Healthcare Group • Belding, MI, US
    Full-time
    Graham Healthcare Group is seeking a Home Health Physical Therapist for a job in Belding, Michigan.Job Description & Requirements. At Mary Free Bed at Home, we’re looking to add to our ext...Show more
    Last updated: 4 days ago • Promoted
    Unit Manager - Sign On Bonus

    Unit Manager - Sign On Bonus

    The Laurels of Hudsonville • HUDSONVILLE, Michigan, United States
    Full-time
    Are you an RN looking for a leadership role? Do you have a passion for leading and teaching other skilled nursing staff? The RN Unit Manager provides, plans, coordinates or manages nursing care and...Show more
    Last updated: 24 days ago • Promoted
    Unit Manager

    Unit Manager

    The Laurels of Hudsonville • HUDSONVILLE, Michigan, United States
    Full-time
    Are you an RN looking for a leadership role? Do you have a passion for leading and teaching other skilled nursing staff? The RN Unit Manager provides, plans, coordinates or manages nursing care and...Show more
    Last updated: 30+ days ago • Promoted
    Physical Therapist

    Physical Therapist

    Interim HealthCare Home Health and Hospice • Greenville, MI, US
    Full-time +2
    Home Health Physical Therapist (PT).Experience a therapy career that caters to your schedule and makes every day an adventure. As a Home Health PT, work-life balance is yours to enjoy and no two day...Show more
    Last updated: 30+ days ago • Promoted
    Travel Nurse RN - Labor and Delivery

    Travel Nurse RN - Labor and Delivery

    PRN Healthcare • Fremont, MI, US
    Full-time
    PRN Healthcare is seeking a travel nurse RN Labor and Delivery for a travel nursing job in Fremont, Michigan.Job Description & Requirements. PRN Healthcare Job ID #1460640.Pay package is based o...Show more
    Last updated: 24 days ago • Promoted
    Travel Nurse RN - Labor and Delivery

    Travel Nurse RN - Labor and Delivery

    Triage Staffing • Fremont, MI, US
    Full-time
    Triage Staffing is seeking a travel nurse RN Labor and Delivery for a travel nursing job in Fremont, Michigan.Job Description & Requirements. Travel Nursing : Labor and Delivery Fremont.Location : ...Show more
    Last updated: 30+ days ago • Promoted
    Home Health Physical Therapist - $80K-120K per year

    Home Health Physical Therapist - $80K-120K per year

    Graham Healthcare Group • Belding, MI, US
    Full-time
    Graham Healthcare Group is seeking a Home Health Physical Therapist for a job in Belding, Michigan.Job Description & Requirements. At Mary Free Bed at Home, we’re looking to add to our extraordinary...Show more
    Last updated: 2 days ago • Promoted
    Moms Ultimate Job : Earn Up to $75,000+ from Home as a Surrogate!

    Moms Ultimate Job : Earn Up to $75,000+ from Home as a Surrogate!

    Physician's Surrogacy • Lowell, MI, US
    Full-time +2
    Earn up to $75,000 as a stay-at-home mom or as a second job.Sign up today and earn $1,200 bonus.What qualities make you a great Surrogate?. Experienced no complications during your own pregnancy.Hea...Show more
    Last updated: 2 days ago • Promoted
    Assistant Director of Nursing (ADON)

    Assistant Director of Nursing (ADON)

    Regency at Fremont • FREMONT, Michigan, United States
    Full-time
    Are you a Registered Nurse (RN) looking for a leadership opportunity with a growing organization? We have an exceptional opportunity for an Assistant Director of Nursing (ADON) to join our team at ...Show more
    Last updated: 30+ days ago • Promoted
    Activity Assistant

    Activity Assistant

    Medilodge of Zeeland • Zeeland, MI, US
    Full-time
    Resident Activity Assistant organizes and participates in person-specific activity programming, including one to one interventions, small group facilitation and large group presentations.Capab...Show more
    Last updated: 30+ days ago • Promoted